Midwest Alternative Family Alliance

MAFA Family Membership Form

Please fill out the requested information below and click on "Submit".  You will be returned to the Get Involved page where you can pay your $25.00 annual membership fee per family via Paypal.

Membership Type:  New                     Renewal
Adult Family Members  
1st Adult (First Name):
1st Adult (Last Name):
1st Adult email address::
2nd Adult (First Name)  
2nd Adult (Last Name)
2nd Adult email address:
Family Mailing Address:  
Address Street 1:
Address Street 2:
Zip Code: (5 digits)
Daytime Phone:
Evening Phone:
 Member Interests:  
  Which of the following interests you and/or your family? (Check all that apply).
   Social Activities (picnics, parties, playgroups)
   Support Groups (group, buddy, mentor, etc.)
   Educational Events
   Charitable or Fundraising Events
   Organizational Support (help with events, marketing, etc)
Additional comments or questions:

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